Inhalation device

ABSTRACT

There is provided an inhalation device suitable for dispensing medicament, particularly medicament for use in the treatment of respiratory disorders. The device comprises a body; a medicament carrier, locatable within said body; a mouthpiece, reversibly movable from a storage position wherein said mouthpiece is within the body to an in-use position wherein a portion of the mouthpiece protrudes from the body and wherein the mouthpiece is in communication with the medicament carrier to allow passage of medicament therebetween; and a mouthpiece actuator coupled to the mouthpiece such that actuation of the mouthpiece actuator moves the mouthpiece towards said storage position and deactuation of the mouthpiece actuator moves the mouthpiece towards the in-use position. The body is shaped to be holdable in one hand and the mouthpiece actuator is actuable in response to a motion of the thumb on the same hand.

This application is filed pursuant to 35 U.S.C. §371 as a U.S. NationalPhase Application of International Application No. PCT/EP99/07080 filedSep. 23, 1999, which claims priority from GB9820938.0 filed Sep. 26,1998 in the United Kingdom.

The present invention relates to an inhalation device for use in theadministration of medicament to a patient. The device has a mouthpiece,which is reversibly retractable from a storage position located insidethe body of the device to a dispensing position in which the mouthpieceprotrudes from the body of the device.

The use of inhalation devices in the administration of medicaments, forexample in bronchodilation therapy, is well known. Such devicesgenerally comprise a body or housing within which a medicament containeris located. A mouthpiece (or nozzle) is typically provided, wherein ‘inuse’ the mouthpiece communicates with the medicament container to allowpassage of medicament from the source to the mouthpiece and thence, tothe patient.

In a typical dispensing operation the body of the device is held by thepatient and the mouthpiece (or nozzle) of the inhalation device isplaced in the mouth (or nose) of the patient. The patient inhales,thereby causing transfer of medicament from the medicament container tothe interior of the body of the patient.

When not in use it is desirable, from a hygiene standpoint, that themouthpiece is provided with some kind of protective cover. The coverdesirably acts both to prevent build-up of dirt on the mouthpiece and toprevent ingress of dirt into the body of the device through themouthpiece, which might then be subject to inhalation by a patient.

It is known to provide the mouthpiece with a protective cap which actsas a protective cover. The cap may either be an entirely separateelement or it may be joined to the body of the device in some way.DE-A-3,639,836, for example, describes a device in which the protectivecap is mounted on an arm, which is pivotally mounted to the body of thedevice.

As an alternative to the use of a protective cap, one might envisage adevice having a mouthpiece which is reversibly retractable from astorage position in which the mouthpiece is contained within the body ofthe device to a dispensing position in which the mouthpiece protrudesfrom the body of the device. In a device of this type the body of thedevice itself acts as the protective cover when the mouthpiece is in thestorage position. The mouthpiece cover is thus an integral part of theinhalation device, avoiding contamination problems of prior artinhalation devices caused by the loss of removable mouthpiece covers.

GB-A-2,074,454 describes an inhalation device comprising a tubular bodyadapted for detachable fitting to an aerosol container. A mouthpiece isprovided, which is movable from a storage position to a dispensingposition by means of a cap, rotatably mounted on the tubular body, whichhas actuating means associated therewith. The cap and tubular body areprovided with openings of similar dimensions. Manual rotation of the capto bring the openings into register causes the actuating means to movethe mouthpiece to the dispensing position in which the mouthpieceprotrudes from the body of the device. Conversely, rotation of the capby the user to bring the openings out of register causes the mouthpieceto be moved to the storage position in which the mouthpiece is containedwithin the body of the device.

For the convenience of the user, it is desirable that the inhalationdevice is arranged to allow movement of the mouthpiece from the storageto dispensing position (and vice-versa) by a one-handed operation. Thedevice described in GB-A-2,074,454 would be very difficult to operate bymeans of a one-handed operation since it requires a rotatory movement ofthe cap relative to the body. This would normally require the user tohold the body in one hand, the cap in another and thence, to perform therequired relative rotatory movement.

The Applicants have now found that the desired one-handed operation canbe facilitated where the device is shaped for ease of grip by the palmand fingers of one hand and where the mouthpiece is actuable by a motionof the thumb of the same hand. One handed operation is thus, forexample, achievable if the user holds the body of the device in the palmof a partially cupped hand and employs the thumb to provide movement tothe mouthpiece actuator, thereby causing actuation of the mouthpiece.

According to one aspect of the present invention there is provided aninhalation device for dispensing medicament comprising

a body;

a medicament carrier;

a mouthpiece, reversibly movable from a storage position wherein saidmouthpiece is within said body to an in-use position wherein a portionof the mouthpiece protrudes from the body and wherein the mouthpiece isin communication with said medicament carrier to allow passage ofmedicament therebetween; and

a mouthpiece actuator coupled to the mouthpiece such that actuation ofsaid mouthpiece actuator moves the mouthpiece towards said storageposition and deactuation of the mouthpiece actuator moves the mouthpiecetowards said in-use position,

wherein said body is shaped to be holdable in one hand and themouthpiece actuator is actuable in response to a motion of the thumb onthe same hand.

The motion of the thumb suitably, but not necessarily, involves contact,and typically engagement, of the thumb with the mouthpiece actuatorresulting in the movement thereof.

In one preferred aspect, the body is shaped to be holdable in the palmof one hand.

In another preferred aspect, the body is shaped to be holdable in thepalm and by at least one of the fingers of one hand.

In a further preferred aspect, the body is shaped to be holdable by aplurality of the fingers of one hand.

Preferably, the mouthpiece actuator is coupled to the mouthpiece suchthat movement of said mouthpiece actuator in a first direction moves themouthpiece towards said storage position and movement of the mouthpieceactuator in an opposing direction moves the mouthpiece towards saidin-use position.

Herein the term ‘mouthpiece’ is used in a generic sense to mean anelement shaped such as to be insertable into the mouth or nose of apatient for inhalation therethrough.

In one preferred aspect, the mouthpiece actuator and mouthpiece arecoupled by a coupling mechanism. In one particularly preferred aspect,the coupling mechanism comprises a rack and pinion mechanism. In anotherparticularly preferred aspect, the coupling mechanism comprises a hingedlever mechanism.

In one aspect the medicament carrier is within the body. In anotheraspect the medicament carrier is attachable to the exterior of the body.

In another preferred aspect, the mouthpiece actuator and mouthpiece aredirectly coupled. Preferably the mouthpiece actuator is a rotatableturning device coupled to the mouthpiece. Alternatively a hinge mountingconnects the mouthpiece to the body. Preferably the hinge mounting issprung such as to bias the mouthpiece to the in-use position.

Preferably, the mouthpiece is comprised of an elastic material.

Preferably, the mouthpiece is provided with a cover comprised of anelastic material.

Preferably, the inhalation device additionally comprises a curtainarrangement contactable by the mouthpiece on movement of the mouthpiecefrom the storage to the in-use position. More preferably, the curtainarrangement comprises a plurality of curtains comprised of anelastomeric material.

Preferably, the mouthpiece actuator is provided with a safety triggermechanism to prevent accidental actuation thereof.

Preferably, at least a portion of the mouthpiece actuator is shaped forease of grip by the user.

Preferably, at least a portion of the mouthpiece actuator has afriction-enhancing coating.

Preferably, the device is provided with a dose counter, which indicatesthe number of doses dispensed from or remaining in the container. Morepreferably, the dose counter comprises an indexing mechanism actuated bya predetermined movement of the medicament container relative to thebody.

Preferably, the medicament container is an aerosol or a dry-powdercontainer.

According to another aspect of the present invention, there is providedthe use of an inhalation device provided herein for dispensingmedicament.

Preferred embodiments of the inhalation device according to the presentinvention will now be described with reference to the accompanyingdrawings in which:

FIG. 1a is a sectional side view of a first inhalation device in accordwith the present invention, wherein the mouthpiece is in the storageposition;

FIG. 1b is a sectional side view of the device of FIG. 1a, wherein themouthpiece is in the in-use position;

FIG. 2a is a perspective view of a second inhalation device herein,wherein the mouthpiece is in the storage position;

FIG. 2b is a perspective view of the device of FIG. 2a, wherein themouthpiece is in the in-use position;

FIG. 3a is a sectional side view of a third inhalation device herein,wherein the mouthpiece is in the storage position;

FIG. 3b is a sectional side view of the device of FIG. 3a, wherein themouthpiece is in the in-use position;

FIG. 4a is a sectional side view of a fourth inhalation device herein,wherein the mouthpiece is in the storage position;

FIG. 4b is a sectional top view of the device of FIG. 4a; and

FIG. 4c is a sectional top view of the device of FIGS. 4a and 4 b,wherein the mouthpiece is in the in-use position.

FIG. 5a is a sectional plan view of a fifth inhalation device in accordwith the present invention;

FIG. 5b is a sectional side view of the device of FIG. 5a, wherein themouthpiece is in the in-use position;

FIG. 5c is a sectional side view of the device of FIG. 5a, wherein themouthpiece is in the storage position;

FIG. 6a is a sectional plan view of a sixth inhalation device in accordwith the present invention;

FIG. 6b is a sectional side view of the device of FIG. 6a;

FIG. 7a is a sectional plan view of a seventh inhalation device inaccord with the present invention;

FIG. 7b is a sectional side view of the device of FIG. 7a wherein themouthpiece is in the storage position;

FIG. 7c is a sectional side view of the device of FIG. 7a and FIG. 7bwherein the mouthpiece is in the in-use position.

FIG. 8a is a front view of an eighth inhalation device in accord withthe present invention;

FIG. 8b is a side view of the device of FIG. 8a wherein the mouthpieceis in the in-use position.

FIG. 9a is a front view of a ninth inhalation device in accord with thepresent invention;

FIG. 9b is a side view of the device of FIG. 9a wherein the mouthpieceis in the storage position.

FIG. 9c is a side view of the device of FIG. 9b wherein the mouthpieceis in the in-use position.

FIGS. 1a and 1 b shows a first inhalation device herein comprising abody 10 having an end cap 16, wherein the end cap 16 is reversiblyattached to the body 10 by a snap fit mechanism 30,32. Within the body10 there is provided a medicament container 20, and integral therewith amouthpiece 90. In the storage position the mouthpiece 90 is keptprotected from outside contamination by cover 50, which comprises anarrangement of elastomeric flaps 52, 54 forming a hygienic curtain. Theintegral medicament container 20 and mouthpiece 90 are mounted fortranslational movement on guide rails 60, 62. An outer face of themedicament container 20 is provided with a series of teeth forming arack 70, which is in communication with first wheel 72 mounted forrotation on the body 10 thereby forming a rack and pinion mechanism. Thefirst wheel 72 also communicates with second wheel 74, which is alsomounted for rotation on the body 10. Rotation of the second wheel 74 isrotationally coupled to that of drive lever 76, which protrudes from thebody 10 making it user accessible.

Actuation of the device from the storage position (shown in FIG. 1a) tothe in-use position (shown in FIG. 1b) is achievable by a user-drivenactuation of the drive lever 76. In practice, this can be achieved by aone-handed operation wherein the body 10 of the device is grippedbetween palm and fingers and the drive lever 76 is rotated by a motionof the thumb. It may be seen that rotation of the device lever 76results in similar rotation of the second wheel 74 and opposite rotationof the first wheel 72, which engages with the rack 70 on the medicamentcontainer thereby driving the integral medicament container 20 andmouthpiece 90, upwardly along the guide rails 60, 62 to the in-useposition. Ejection of the medicament container 20 from the body 10 isprevented by stops 64, 66.

It may also be seen that on actuation the mouthpiece 90 impacts with,and causes a parting, of the protective curtain arrangement 52, 54. Inan improvement herein, the curtains 52, 54 may be provided with afriction cleaning surface or coating such that the mouthpiece is cleanedof any dust particles, dirt etc., when it contacts the curtains.Deactivation of the device is achievable by the reverse rotation of thedrive lever 76.

FIGS. 2a and 2 b show a second inhalation device herein having anactuation mechanism (not shown in detail) similar to that of the deviceof FIGS. 1a and 1 b. The device comprises a body 110 having a reversiblyremovable end cap 116. Within the body there is provided an integralmedicament cartridge (not visible) and mouthpiece 190. A protectivecover 150 is provided to the end cap 116, wherein the cover 150 preventsingress of dirt and contamination to the mouthpiece 190 within the body110. The drive lever 76 of the device of FIGS. 1a and 1 b is replaced bya rotationally mounted drive cylinder 176, which has a grooved surfacefor ease of grip. It may be appreciated that the body 110 is shaped forease of grip within the palm of a user's hand and the drive cylinder 176is arranged for ease of rotation by a thumb motion. Actuation of thedevice is achievable by rotation of the drive cylinder 176 towards theend cap 116 and deactivation is achievable by the reverse rotatorymovement.

FIGS. 3a and 3 b shows a third inhalation device herein comprising abody 210 having a reversibly detachable side position 216, which isshaped for ease of grip. Within the body 210 there is provided amedicament container 220. Also provided is mouthpiece 290, whichcommunicates with the medicament container through a connecting passage225 when the mouthpiece is in the in-use position. The mouthpiece 290 ismounted on worm 270, such that the worm 270 is rotationally movabletherewithin. The worm 270 is provided at the lower end with a worm drivewheel 272, which communicates with a second wheel 274 mounted on thebody 210, which second wheel 274 communicates with a motor drive wheel276. The motor drive wheel is driven by motor 277 powered by battery278. A user accessible switch 279 is provided for actuation of the motor278.

Rotation of the mouthpiece 290 is prevented by the presence of stub 292on the mouthpiece 290. The stub 292, and hence mouthpiece 290, ismounted on movable guide rails 260, 262 having first and second endstops 264, 266 corresponding respectively to the mouthpiece storage andin-use positions. The upper end 266 of the movable guide railarrangement 260, 262 is attached to a sliding door 250. The sliding door250 is closed when the mouthpiece 290 is in the storage position therebyforming a protective cover. The door 250 is slidably openable inresponse to actuation of the mouthpiece 290, thereby allowing themouthpiece 290 to protrude through the door opening.

Actuation of the device from the storage position (shown in FIG. 3a) tothe in-use position (shown in FIG. 3b) is achievable by user actuationof the switch 279. It may be appreciated that the device as a whole isshaped for one-handed operation involving gripping of the end cap 216 bythe fingers and thumb actuation of the switch 279. On actuation themotor 277 rotationally drives motor drive wheel 276, in turn causingrotation of the second wheel 274, worm drive wheel 272 and hence worm270. The upward rotational movement of the worm 270 causes themouthpiece 290 and stub 292 thereon to be driven upwards along a pathdefined by the axis of rotation of the worm 270.

Since the stub 292 is mounted on the guide rail arrangement 260, 262, itmay be seen that the upwards movement of the stub 292 causes the shapedguide rails 260, 262 to be driven sideways (from left to right asshown), hence enabling opening of the sliding door 250, which is itselfattached to the upper end 266 of the guide rail arrangement 260, 262.

Deactuation of the device is achievable by a second actuation actuationof the switch 279, which results in the opposite motor-driven rotationof the gear assembly 272, 274, 276 and worm drive 270.

FIGS. 4a, 4 b and 4 c show a fourth inhalation device herein comprisinga disk-shaped body 310. At three equally spaced positions on theperiphery of the disk-shaped body 310 there are provided actuation pads360, 362, 364. The pads 360, 362, 364 are shaped for ease of grip by auser. Three equally spaced slits are also provided on the periphery ofthe body 310 for receipt of actuating pins 314, 316, 318 mounted on theinterior of each pad 360, 362, 364, which pins 314, 316, 318 protrudeinto the body 310. Compression of an actuating pad 360, 362, 364relative to the body 310 thus results in movement of a pin 314, 316, 318into the slits, and hence its insertion deeper into the body 310. Whenso inserted, the pin 314, 316, 318 contacts generally disk-shaped plate370, which is mounted for rotation within the body 310, causing rotationthereof. FIG. 4c shows a device in which pad 360 has been compressedmoving pin 314 into the body 310 and into contact with plate 370, whichhas thus been rotated.

Within the body 310 there is provided a medicament container 320 andintegral therewith a mouthpiece 390. The mouthpiece 390 is connected tothe generally disk-shaped plate 370 by pivotally mounted arms. FIGS. 4a,thus shows arm 392 mounted to the plate 370 at pivot point 394, whicharm is itself mounted to mouthpiece 390. The arm 392 contacts atriangular cam surface 396 provided on the body 310. When the plate 370is rotated the contact of the arms 392 with the camming surface resultsin the arms 392, and hence the mouthpiece 390, being urged upwardlytowards a circular opening 312 in the body. In the storage position theopening 312 is closed off by an iris shutter mechanism comprising threeshaped doors 350, 352, 354 capable of forming a circular closure. Eachof the doors 350, 352 354 is pivotally mounted to the generallydisk-shaped plate 370 at pivot points 351, 353 and 355.

The iris closure is generally urged towards the closed position by leafspring mechanisms 394, 396, 398. The rotation of the pate 370 relativeto the body 310 may, thus, be seen to allow for opening and closing ofthe iris shutter mechanism. Rotation of the plate 370 is initiated byits drivable contact by one or more of the actuating pins 314, 316, 318.

A lock mechanism is further provided, which allows for reversablelocking of the device in the ‘in-use’ (i.e. iris shutter open andmouthpiece protruding) position. The locking mechanism comprises lockingarm 340 mounted at a first end at pivot point 342 to the body 310. Thesecond end of the arm is provided with a stub 344, which is mounted fortravel on irregular-shaped track 346 provided in the plate 370. As theplate 370 is rotated, the stub 344 moves along the track 346 until it isretainably received by valley 348 in the track 346, which corresponds tothe locking position. Unlocking is achieved by further rotation of theplate 370, which allows for release of the stub 344 from the valley 348in the track 346.

Actuation of the device from the storage position (shown in FIGS. 4a and4 b) to the in-use position (shown in FIG. 4c) is achievable by auser-driven compression of one or more of the actuating pads 360, 362,364. It will be appreciated that such compressive force may beconveniently achieved by a user holding the body 310 of the device in acupped hand and using the thumb to squeeze down one of the actuatingpads 360, 362, 364. Compression of an actuating pad 360, 362, 364results in an actuating pin 314, 316, 318 being pushed into the body 310of the device. The actuating pin 314, 316, 318 contacts the plate 370causing rotation thereof, which rotation in turn results in the openingof the iris shutter mechanism, and ejection of the mouthpiece 390 fromthe opening 312 thereby revealed in the body 310. The iris shutter andmouthpiece are locked into the ‘in use’ position by the hereinbeforedescribed locking mechanism. Deactuation is achieved by application offurther compressive force to an actuating pad 360, 362, 364 resulting infurther insertion of a pin 314, 316, 318 which in turn further rotatesthe plate 370, and, thus, results in unlocking of the lock mechanism.The plate 370 may then rotate back to its start position under theinfluence of the spring mechanism 394, 396, 398 which also causesclosing of the iris shutter.

FIGS. 5a, 5 b and 5 c show a first inhalation device herein comprising abody 410 having an end cap 416, wherein the end cap 416 is reversiblyattached to the body 410 by a snap fit mechanism 430, 432. Within thebody there is provided a medicament container 420, which is incommunication with a hollow transition piece 440 also provided in saidbody 410.

An essentially flat cover 450 is retainably mounted on first and secondguide rails 460, 462 provided on a first face of the body 410 forslidable movement thereon. The exterior surface of the cover 450 hascontours 452 for ease of grip by the thumb of the user. The interiorsurface of the cover 450 communicates with first and second rack pinionmechanisms 470, 480 which are aligned with the axes defined by the firstand second guide rails 460, 462. Each of the first and second rack andpinion mechanisms 470, 480 (wherein, for clarity, only the firstmechanism is shown in detail on FIGS. 5b and 5 c) comprises a first rack472, 482 attached to the cover 450, which communicates with a wheel 474,484 axially mounted to the body 410, which wheel 474, 484 communicateswith a curved second rack 476 which is mounted for communication withthe mouthpiece 490.

Actuation of the device from the storage position (shown in 5 c) to thein-use position) (shown in FIGS. 5a and 5 c) is achievable by the userholding the body 410 in a cupped palm and using a thumb motion to slidethe cover 450 along the guide rails 460, 462 in a direction towards theend cap 416. The first rack 472 is thus bought into engagement withwheel 474, which rotates and engages second rack 476, thereby moving thesecond rack 476 in the opposite direction. In turn, the movement of thesecond rack 476 causes the mouthpiece 490 to be moved to the in-useposition, in which it protrudes from the body 410. In the in-useposition it may be seen that the interior of the mouthpiece 490communicates with the hollow interior of the transition piece 440, whichitself communicates with the medicament container 420. Thus aninhalation passageway is provided from the mouthpiece 490 to themedicament container 420. Deactivation is achievable by the reversesliding motion of the cover 450.

FIGS. 6a and 6 b shows a sixth inhalation device herein comprising abody 510, which is overall shaped for ease of grip in the hand of auser. Within the body 510 there is provided a medicament cartridge 520and attached thereto mouthpiece 590, wherein the mouthpiece is comprisedof a resiliently deformable elastomeric material. A shaped cover 550 isretainably mounted on first and second guide rails 560, 562 provided onthe body 510 for slidable movement thereon.

Actuation of the device from the storage position (shown in FIG. 6a) tothe in-use position (shown in FIG. 6b) is achievable by the usergripping the body 510 of the device in a partially cupped palm and usingthe thumb to slide the cover 550 along the guide rails 560, 562, therebyrevealing the mouthpiece 590, which ‘pops out’ into its characteristicshape. Deactivation is achievable by the reverse sliding action, whichcauses deformation of the mouthpiece 590.

FIGS. 7a, 7 b and 7 c show a seventh inhalation device herein comprisinga body 610 provided with a medicament compartment 620 which isaccessible for loading of medicament by opening of door 622. Contouredelastomeric strips 616, 618 are provided to the body 610 for ease ofgrip thereof by the hand of a user.

A circular, essentially flat cover 650 is retainably mounted on thefirst and second guide rails 660, 662 provided on the body 610. Theinterior surface of the cover 650 is coupled through articulatedassembly 670 to mouthpiece 690, which is itself hingedly mounted. Themouthpiece 690 is provided with a thin, flexible elastomeric covering692.

Actuation of the device from the storage position (shown in FIGS. 7a and7 b) to the in-use position (shown in FIG. 7c) is achievable by the userholding the body 610 of the device in one hand and using the thumb toslidably move the cover 650 along the guide rails 660, 662. The slidingaction is coupled via articulated assembly 670 to the mouthpiece 690,which is moved to a position in which it stands proud from the body 610,and in which there is an inhalation passageway established between themouthpiece 690 and the medicament compartment 620. Deactivation isachievable by performance of the reverse sliding action.

FIGS. 8a and 8 b show an inhalation device herein comprising a body 710,within said body 710 there is provided a hidden mouthpiece 790 and amedicament cartridge (not visible). A protective cover 750 of themouthpiece 790 is provided which prevents ingress of dirt andcontamination to the mouthpiece 790 within the body 710. The protectivecover 750 is reversibly slidable to expose or cover hidden retractedmouthpiece 790.

There is provided a rotationally mounted drive cylinder 774, which has agrooved surface for ease of grip. It may be appreciated that the body710 is shaped for ease of grip within the palm of a user's hand and thedrive cylinder 774 is arranged for ease of rotation by a thumb motion.Actuation of the mouthpiece 790 is achievable by rotation of the drivecylinder 774 and deactuation is achievable by the reverse rotarymovement.

FIGS. 9a, 9 b and 9 c show an inhalation device herein comprising a body810, within said body there is provided a hidden mouthpiece 890 and amedicament cartridge (not visible). A protective cover 850 of themouthpiece 890 is provided which prevents ingress of dirt andcontamination to the mouthpiece 890 within the body 810. The protectivecover 850 is reversibly slidable to expose or cover hidden retractedmouthpiece 890. There is provided a spring mounted hinge (not visible)on the mouthpiece 890, which allows the mouthpiece 890 to spring intothe in-use position following movement of the protective mouthpiececover 850 to expose the stored mouthpiece 890.

The body 810 of the inhalation device is shaped to fit within the user'shand. Actuation of the device from the storage position to the in-useposition is achievable by using the thumb of the same hand to slidablymove the protective mouthpiece cover 850, allowing the hinged mouthpiece890 to move into the in-use position. Deactuation of the mouthpiece isachievable by using the thumb to move the mouthpiece 890 back to thestorage position and to slide the protective mouthpiece cover 850 sothat it covers the mouthpiece 890 again.

The inhalation device herein is suitable for dispensing medicament,particularly for the treatment of respiratory disorders. Appropriatemedicaments may thus be selected from, for example, analgesics, e.g.,codeine, dihydromorphine, ergotamine, fentanyl or morphine; anginalpreparations, e.g., diltiazem; antiallergics, e.g., cromoglycate,ketotifen or nedocromil; antiinfectives e.g., cephalosporins,penicillins, streptomycin, sulphonamides, tetracyclines and pentamidine;antihistamines, e.g., methapyrilene; anti- inflammatories, e.g.,beclomethasone dipropionate, fluticasone propionate, flunisolide,budesonide, rofleponide, mometasone furoate or triamcinolone acetonide;antitussives, e.g., noscapine; bronchodilators, e.g., albuterol,salmeterol, ephedrine, adrenaline, fenoterol, formoterol, isoprenaline,metaproterenol, phenylephrine, phenylpropanolamine, pirbuterol,reproterol, rimiterol, terbutaline, isoetharine, tulobuterol, or(−)-4-amino-3,5-dichloro-α-[[[6-[2-(2-pyridinyl)ethoxy]hexyl]methyl]benzenemethanol; diuretics, e.g., amiloride; anticholinergics, e.g.,ipratropium, tiotropium, atropine or oxitropium; hormones, e.g.,cortisone, hydrocortisone or prednisolone; xanthines, e.g.,aminophylline, choline theophyllinate, lysine theophyllinate ortheophylline; therapeutic proteins and peptides, e.g., insulin orglucagon. It will be clear to a person skilled in the art that, whereappropriate, the medicaments may be used in the form of salts, (e.g., asalkali metal or amine salts or as acid addition salts) or as esters(e.g., lower alkyl esters) or as solvates (e.g., hydrates) to optimisethe activity and/or stability of the medicament.

Preferred medicaments are selected from albuterol, salmeterol,fluticasone propionate and beclomethasone dipropionate and salts orsolvates thereof, e.g., the sulphate of albuterol and the xinafoate ofsalmeterol.

Medicaments can also be delivered in combinations. Preferredformulations containing combinations of active ingredients containsalbutamol (e.g., as the free base or the sulphate salt) or salmeterol(e.g., as the xinafoate salt) in combination with an anti-inflammatorysteroid such as a beclomethasone ester (e.g., the dipropionate) or afluticasone ester (e.g., the propionate).

It will be understood that the present disclosure is for the purpose ofillustration only and the invention extends to modifications, variationsand improvements thereto.

The application of which this description and claims form part may beused as a basis for priority in respect of any subsequent application.The claims of such subsequent application may be directed to any featureor combination of features described therein. They may take the form ofproduct, method or use claims and may include, by way of example andwithout limitation, one or more of the following claims:

What is claimed is:
 1. An inhalation device for dispensing medicamentcomprising a body; a medicament carrier; a mouthpiece, reversiblymovable from a storage position wherein said mouthpiece is within saidbody to an in-use position wherein a portion of the mouthpiece protrudesfrom the body and wherein the mouthpiece is in communication with saidmedicament carrier to allow passage of medicament therebetween; and amouthpiece actuator coupled to the mouthpiece such that actuation ofsaid mouthpiece actuator moves the mouthpiece towards said storageposition and deactuation of the mouthpiece actuator moves the mouthpiecetowards said in-use position, wherein said body is shaped to be holdablein one hand and the mouthpiece actuator is actuable in response to adiscrete motion of the thumb on the same hand, and the mouthpieceactuator and mouthpiece are directly coupled.
 2. An inhalation deviceaccording to claim 1 wherein the mouthpiece actuator is a rotatableturning device coupled to the mouthpiece.
 3. Use of an inhalation deviceaccording to claim 1 for dispensing medicament.
 4. An inhalation devicefor dispensing medicament comprising a body; a medicament carrier; amouthpiece, reversibly movable from a storage position wherein saidmouthpiece is within said body to an in-use position wherein a portionof the mouthpiece protrudes from the body and wherein the mouthpiece isin communication with said medicament carrier to allow passage ofmedicament therebetween; and a mouthpiece actuator coupled to themouthpiece such that actuation of said mouthpiece actuator moves themouthpiece towards said storage position and deactuation of themouthpiece actuator moves the mouthpiece towards said in-use position,wherein said body is shaped to be holdable in one hand and themouthpiece actuator is actuable in response to a discrete motion of thethumb on the same hand, and the medicament carrier is attachable to theexterior of the body.
 5. An inhalation device according to claim 4,wherein the mouthpiece is comprised of an elastic material.
 6. Aninhalation device according to claim 4, wherein the mouthpiece isprovided with a cover comprised of an elastic material.
 7. An inhalationdevice according to claim 4, wherein at least a portion of themouthpiece actuator is shaped for ease of grip by the user.
 8. Use of aninhalation device according to claim 4 for dispensing medicament.
 9. Aninhalation device for dispensing medicament comprising a body; amedicament carrier; a mouthpiece, reversibly movable from a storageposition wherein said mouthpiece is within said body to an in-useposition wherein a portion of the mouthpiece protrudes from the body andwherein the mouthpiece is in communication with said medicament carrierto allow passage of medicament therebetween; and a mouthpiece actuatorcoupled to the mouthpiece such that actuation of said mouthpieceactuator moves the mouthpiece towards said storage position anddeactuation of the mouthpiece actuator moves the mouthpiece towards saidin-use position, wherein said body is shaped to be holdable in one handand the mouthpiece actuator is actuable in response to a discrete motionof the thumb on the same hand, and additionally comprising a curtainarrangement contactable by the mouthpiece on movement of the mouthpiecefrom the storage to the in-use position.
 10. An inhalation deviceaccording to claim 9, wherein said curtain arrangement comprises aplurality of curtains comprised of an elastomeric material.
 11. Aninhalation device according to claim 9, wherein the medicament containeris an aerosol.
 12. Use of an inhalation device according to claim 9 fordispensing medicament.
 13. An inhalation device for dispensingmedicament comprising a body; a medicament carrier; a mouthpiece,reversibly movable from a storage position wherein said mouthpiece iswithin said body to an in-use position wherein a portion of themouthpiece protrudes from the body and wherein the mouthpiece is incommunication with said medicament carrier to allow passage ofmedicament therebetween; and a mouthpiece actuator coupled to themouthpiece such that actuation of said mouthpiece actuator moves themouthpiece towards said storage position and deactuation of themouthpiece actuator moves the mouthpiece towards said in-use position,wherein said body is shaped to be holdable in one hand and themouthpiece actuator is actuable in response to a discrete motion of thethumb on the same hand, and the mouthpiece actuator is provided with asafety trigger mechanism to prevent accidental actuation thereof. 14.Use of an inhalation device according to claim 13 for dispensingmedicament.
 15. An inhalation device for dispensing medicamentcomprising a body; a medicament carrier; a mouthpiece, reversiblymovable from a storage position wherein said mouthpiece is within saidbody to an in-use position wherein a portion of the mouthpiece protrudesfrom the body and wherein the mouthpiece is in communication with saidmedicament carrier to allow passage of medicament therebetween; and amouthpiece actuator coupled to the mouthpiece such that actuation ofsaid mouthpiece actuator moves the mouthpiece towards said storageposition and deactuation of the mouthpiece actuator moves the mouthpiecetowards said in-use position, wherein said body is shaped to be holdablein one hand and the mouthpiece actuator is actuable in response to adiscrete motion of the thumb on the same hand, and at least a portion ofthe mouthpiece actuator has a friction-enhancing coating.
 16. Use of aninhalation device according to claim 15 for dispensing medicament. 17.An inhalation device for dispensing medicament comprising a body; amedicament carrier; a mouthpiece, reversibly movable from a storageposition wherein said mouthpiece is within said body to an in-useposition wherein a portion of the mouthpiece protrudes from the body andwherein the mouthpiece is in communication with said medicament carrierto allow passage of medicament therebetween; and a mouthpiece actuatorcoupled to the mouthpiece such that actuation of said mouthpieceactuator moves the mouthpiece towards said storage position anddeactuation of the mouthpiece actuator moves the mouthpiece towards saidin-use position, wherein said body is shaped to be holdable in one handand the mouthpiece actuator is actuable in response to a discrete motionof the thumb on the same hand, and the medicament container is adry-powder container.
 18. Use of an inhalation device according to claim17 for dispensing medicament.
 19. An inhalation device for dispensingmedicament comprising a body; a medicament carrier; a mouthpiece,reversibly movable from a storage position wherein said mouthpiece iswithin said body to an in-use position wherein a portion of themouthpiece protrudes from the body and wherein the mouthpiece is incommunication with said medicament carrier to allow passage ofmedicament therebetween; and a mouthpiece actuator coupled to themouthpiece such that actuation of said mouthpiece actuator moves themouthpiece towards said storage position and deactuation of themouthpiece actuator moves the mouthpiece towards said in-use position,wherein said body is shaped to be holdable in one hand and themouthpiece actuator is actuable in response to a discrete motion of thethumb on the same hand, and the device is provided with a dose counter.20. An inhalation device according to claim 19 wherein the dose countercomprises an indexing mechanism actuated by a predetermined movement ofthe medicament container relative to the body.
 21. Use of an inhalationdevice according to claim 19 for dispensing medicament.